| Objective:To investigate the influence of different levels of fundus tessellation on the retinal choroid in the macular area,and explore the possibility related to the classification of fundus tessellation in myopia Influencing factors.Method:Our research group will establish a prospective cohort study of healthy people with high myopia In Yunnan Province,and will carry out a 10-year follow-up observation.From August 2019 to March 2021,our research team has recruited more than 300 myopia patients from Yunnan Province and surrounding areas in the ophthalmology clinic of the First Affiliated Hospital of Kunming Medical University.In this study,subjects were selected from the baseline database.After strict screening,176 myopia patients and 326 eyes were finally included.We measure the patient’s sphere equivalent power(SE),best corrected visual acuity(BCVA),eye axis length,superficial and deep capillary plexus vessel density of the retina,macular retinal thickness,subfoveal choroidal thickness(SFCT),choroidal capillary vessel density by using Angio-OCT,fundus photography,IOL-Master and other Ophthalmic examination equipment.We designed an electronic questionnaire to collect general patient information(including gender,age,family history,general medical history,etc.).All the inspected eyes were divided into high myopia group(spherical power≤-6.0D)and low-medium myopia group(spherical power>-6.0D)according to the degree of subjective refraction spherical power.Fundus tessellation was graded using 45-degree colour fundus photographs centred on fovea.Adopting the Early Treatment Diabetic Retinopathy Study Grid(ETDRS Grid),myopic fundus tessellation was classified into four grades(grade 0,grade 1,grade 2,grade 3).Compare the biological parameters of different levels of fundus tessellation groups and conduct correlation analysis.Finally,the statistically significant variables in the correlation analysis were included in the multivariate ordered logistic regression analysis.A p-value less than 0.05 indicates that the difference between the two groups is statistically significant.Results:The study included 52 males(29.5%)and 124 females(70.5%);the average age of 32.63±10.94 years old,the average spherical equivalent of-7.92±3.04 D,the average best corrected visual acuity of 0.94±0.14,and the average eye axis length of 26.47±1.46 mm.High myopia group:256 eyes,after grading the degree of fundus tessellation:Grade 0:13 eyes(5.1%);Grade 1:52 eyes(20.30%);Grade 2:68 eyes(26.60%);Grade 3:123 eyes(48.05%).Low-medium myopia group:70 eyes.after grading the degree of fundus tessellation:Grade 0:14 eyes(20%);Grade 1:26 eyes(37.14%);Grade 2:15 eyes(21.43%);Grade 3:15 eyes(21.43%).Low-medium myopia group:level 0-3 with different degrees of fundus tessellation,there was no statistically significant difference in spherical equivalent power,axial length,DCP and SCP vessel density in different areas of the macula,retinal thickness in different areas of the macula,choroidal capillary(P>0.05);while there was a significant statistical difference in the thickness of the subfoveal choroidal thickness(SFCT).Correlation analysis:the fundus tessellation grading and the subfoveal choroidal thickness were significantly negative Correlation(r=-0.603,P<0.001).High myopia group:0-3 different degrees of fundus tessellation,There were statistically significant differences in spherical equivalent power,axial length,retinal thickness in the parafoveal area,retinal thickness in the area around the fovea,and SCP vessel density in the parafoveal area,subfoveal choroidal thickness and choroidal capillary density in the macular area(P<0.05),There were no statistically significant differences in best corrected visual acuity,retinal thickness in the foveal area,SCP and DCP vessel density in the foveal area,DCP vessel density in the para-foveal area,and DCP vessel density in the peri-foveal area(P>0.05).Correlation analysis:the grading of the fundus tessellation is positively correlated with the axis of the eye(r=0.381,P<0.001);with the equivalent spherical power(r=-0.319,P<0.001),and the retinal thickness in the parafoveal area(r=-0.309,P<0.001),retinal thickness in the area around the fovea(r=-0.305,P<0.001),SCP vessel density in the paramacular fovea area(r=-0.20,P<0.05),SCP in the area around the fovea Blood flow density(r=-0.17,P<0.05),subfoveal choroidal thickness(r=-0.595,P<0.001),and macular area choroidal capillary density(r=-0.224,P<0.001)were all negative related.Incorporating these related factors into logistic regression analysis,the results showed:the severity of the fundus tessellation of high myopia and the axial length(OR=1.82,95%CI:1.318～2.513,P<0.001),the subfoveal choroidal thickness(OR=0.982,95%CI:0.977～0.986,P<0.001),parafoveal retinal thickness(OR=0.964,95%CI:0.937～0.992,P<0.05)were all related.In the Low-medium myopia group,Logistic regression analysis of subfoveal choroidal thickness was performed.Results:The degree of the fundus tessellation was correlated with the subfoveal choroidal thickness(OR=0.979,95%CI:0.970～0.987,P<0.05).Conclusion:1.In patients with high myopia,the growth of the eye axis length,the thinning of the parafoveal retina thickness,and the thinning of the subfoveal choroidal thickness are the risk factors for the aggravation of the fundus tessellation.In patients with low and medium myopia,the thinning of the subfoveal choroidal thickness are the risk factors for the aggravation of the fundus tessellation.2.In patients with high myopia,the degree of fundus tessellation is increased,and the SCP-VD and thickness in the parafovea and perifovea aera are reduced;In patients with low and medium myopia,the degree of fundus tessellation is increased,there was no obvious change in retina vessel density and thickness.3.In all myopia patients,the thinner the thickness of the subfoveal choroid,the more severe of the fundus tessellation.In patients with high myopia,when the fundus tessellation involves the macular area,the choroidal capillary density decreases significantly,while in patients with low and medium myopia,as the degree of fundus tessellation in patients with low and medium myopia worsened,the choroidal capillary density did not change significantly.4.The severity of fundus tessellation changes is closely related to the thickness of the choroid under the fovea,which can be used as a clinical sign of choroidal thinning. |
